Continuing Medical Education (CME)

Technical Update: Scalpel used in laparoscopic surgery

Recent developments in energized dissection technology have revolutionized both open and especially laparoscopic surgery by allowing the division and coagulation of tissues without the need for cumbersome suture ligation.

The surgical use of heat is not a new innovation. Hippocrates used heat to burn a cancerous growth on a man’s neck.Heat generated by electrosurgery was introduced by Cushing in 1928, when he reported dessication, cutting and coagulation during intracranial surgery using a device produced by Bovie.

With the emergence of laparoscopic surgery in the 1970’s, the use of monopolar electrosurgery was extensively used, however with reports of bowel injury occurring due to electrical arcing a search began to develop a safer mode of electrosurgery. The development of bipolar electrosurgery in 1974 by Rioux for laparoscopic tubal sterilization was the first of a new generation of devices. Inadvertent bowel injury is still a concern with electrosurgery. This concern has resulted in the search for safer modalities for the management of laparoscopic cutting and coagulation.